Varicose veins, a manifestation of chronic venous insufficiency, result from valvular dysfunction and venous hypertension. The prevalence ranges from 20% to 40% in adults, with a higher incidence in older adults and women. The key risk factors include genetic predisposition, age, female sex, standing occupation, and pregnancy. Although often viewed as a cosmetic concern, it can lead to discomfort and severe health issues. The pathophysiology of varicose veins is rooted in valvular dysfunction and the resultant venous hypertension. An accurate diagnosis involves a combination of thorough history-taking, physical examination, and duplex ultrasonography (DUS). Early diagnosis and intervention are paramount not only in alleviating symptoms but also in preventing the deterioration of the underlying chronic venous insufficiency. Treatment options span a spectrum from conservative measures, such as compression therapy and venoactive substances, to a variety of interventional approaches, such as endovenous thermal or nonthermal ablation techniques, foam sclerotherapy, and surgical procedures. Each case necessitates personalized assessment to determine the most suitable treatment approach. This chapter comprehensively reviews the pathophysiology, clinical presentation, diagnosis, and treatment modalities of varicose veins.